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Background: Improving the quality of primary healthcare provision is a key goal in low-and middle-income countries (LMICs). However, to develop effective quality improvement interventions, we first need to be able to accurately measure the quality of care. The methods most commonly used to measure the technical quality of care all have some key limitations in LMICs settings. Video-observation is appealing but has not yet been used in this context. We examine preliminary feasibility and acceptability of video-observation for assessing physician quality in a hospital outpatients' department in Nigeria. We also develop measurement procedures and examine measurement characteristics.Methods: Cross-sectional study at a large tertiary care hospital in Ibadan, Nigeria. Consecutive physician-patient consultations with adults and children under five seeking outpatient care were video-recorded. We also conducted brief interviews with participating physicians to gain feedback on our approach. Video-recordings were double-coded by two medically trained researchers, independent of the study team and each other, using an explicit checklist of key processes of care that we developed, from which we derived a process quality score. We also elicited a global quality rating from reviewers.Results: We analysed 142 physician-patient consultations. The median process score given by both coders was 100 %. The modal overall rating category was 'above standard' (or 4 on a scale of 1-5). Coders agreed on which rating to assign only 44 % of the time (weighted Cohen's kappa = 0.26). We found in three-level hierarchical modelling that the majority of variance in process scores was explained by coder disagreement. A very high correlation of 0.90 was found between the global quality rating and process quality score across all encounters. Participating physicians liked our approach, despite initial reservations about being observed.Conclusions: Video-observation is feasible and acceptable in this setting, and the quality of consultations was high. However, we found that rater agreement is low but comparable to other modalities that involve expert clinician judgements about quality of care including in-person direct observation and case note review. We suggest ways to improve scoring consistency including careful rater selection and improved design of the measurement procedure for the process score. [ABSTRACT FROM AUTHOR]

This study compared knowledge and compliance with traffic signs among young commercial motorcyclists in rural and urban communities in Oyo state, Nigeria. Information on knowledge and compliance with 10 common traffic signs was obtained from 149 rural and 113 urban commercial motorcyclists aged 18–35 years. Aggregate knowledge scores were computed and categorized as good (≥5) and poor (<5) knowledge. Overall, 98.7% rural versus 61.1% urban motorcyclists had poor knowledge of traffic signs (p< 0.05). After controlling for age, level of education and years of commercial riding, motorcyclists in the rural areas were more likely to have poor knowledge of the traffic signs (OR = 58.15; 95% CI = 11.96–282.79). A higher proportion of rural than urban motorcyclists never obeyed any of the traffic signs. Young rural commercial motorcyclists' knowledge and compliance with the road signs was poorer than their urban counterparts. Interventions to improve the rural motorcyclists' knowledge and ultimately compliance with road signs are urgently required. [ABSTRACT FROM PUBLISHER]

Objective:This study examined the association between young age and poor road safety practices of commercial motorcyclists in Oyo state, Nigeria. Methods:A cross-sectional study of 371 commercial motorcyclists selected via a multistage sampling technique was conducted. Information on sociodemographic characteristics and road safety practices (possession of a valid license, helmet use, number of passengers carried per trip, and compliance with 10 selected traffic signs) was obtained with the aid of an interviewer-administered questionnaire. Individual road safety practice items were scored and a total score was obtained giving minimum and maximum obtainable scores of 0 and 35. Respondents with scores ≤ 17.5 (i.e., less than or equal to half of the maximum obtainable score of 35) were categorized as having poor road safety practices. Descriptive statistics, chi-square, and multiple logistic regression tests were conducted. Selected sociodemographic and occupation-related factors were controlled for in the logistic regression analysis. Results:All respondents were male, 80.1% had been riding for commercial purposes for less than 5 years, and 73.0% had other jobs in addition to commercial riding. Road safety practices were generally poor; that is, 84.4% of commercial riders were categorized as having poor road safety practices. Almost all (98.6%) respondents aged < 25 years compared to 84.3% of those aged 25 to <35 years and 76.8% of those ≥35 years had poor road safety practices. This difference was statistically significant. Following logistic regression, younger age (<25 years) remained predictive of poor road safety practices. Motorcyclists aged < 25 years had about 16 times higher odds of having poor road safety practices compared to those aged 35 years and more (odds ratio = 15.72, 95% confidence interval, 1.82–135.91). Conclusion:Most studies conduct only bivariate analysis to test the association between age and road practices of commercial motorcyclists; however, we investigated the influence of potential confounding variables using multivariate analysis. Our findings confirmed young age as a predictor of poor road safety practices among our sample of commercial motorcyclists and emphasizes the need for road safety programs to target this category of riders. The current minimum age for obtaining a rider's license in Nigeria is 18 years; our findings suggest that it might be beneficial to increase the age at which riders in our study area can obtain a commercial rider's license to above 25 years. [ABSTRACT FROM PUBLISHER]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The increasing number of the elderly persons and their attendant health problems has implications on public health programs in developing countries. However, there is limited information on the elderly residing outside major cities in Nigeria. Therefore, this study was conducted to determine and compare prevalent health problems and associated risk factors in the elderly of urban and rural communities in Oyo State, Nigeria. Materials and Methods: A comparative cross-sectional survey of consenting adults aged 60 years and above in Iseyin (urban) and Ilua (rural) communities of Oyo State in south-west, Nigeria. Using cluster sampling technique, a total of 630 respondents; 316 in the urban and 314 in the rural participated. Information was sought on the respondents' socio-demographic characteristics, life style, self-reported health problems. Anthropometric measurements and clinical examination including blood pressure measurements and visual acuity were conducted. Results: The mean age of urban respondents was 72.2 ± 9.5 years compared with 70.8 ± 8.1 years in the rural. There were more females (61.1%) than males (38.9%) in both the locations. Self-reported health problems in both locations were similar and included reduced sexual fulfillment, musculoskeletal problems such as muscular and low back pain. On clinical examination, the main health problems were visual impairment 58.7% in the urban versus 41.7% in the rural (P < 0.001). Prevalence of hypertension among urban and rural respondents was 38.3% and 34.7%, respectively (P = 0.35). Osteoarthritis was significantly higher 8.5% in urban than 3.2% obtained in rural (P = 0.004v). On multivariate analysis, female gender, increasing body mass index, and low monthly income were significant predictors of hypertension in both locations. Conclusions: Cardiovascular, musculoskeletal, and visual noncommunicable diseases were prevalent in both elderly populations. Social conditions and gender play important role in the health status of the elderly. [ABSTRACT FROM AUTHOR]

Background The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. Methods Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets. Findings 5563 helmet-wearing motorcyclists were observed; 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed; those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets; across all countries, regardless of outlet type, standard helmets were generally 2-3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal. Interpretation Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing campaigns. [ABSTRACT FROM AUTHOR]

The researchers in this study assessed the prevalence of different types and experience of intimate partner violence among 600 women aged 15 to 49 years in selected rural and urban communities in southwestern Nigeria between October and December, 2007. Lifetime prevalence of intimate partner violence was 64% in the rural and 70% in the urban areas. Controlling behavior was the most frequently reported type of intimate partner violence experienced by both groups of women, and sexual violence was reported least. More urban women reported sexual violence and controlling behaviors than rural women (16.4% versus 11.6% and 57.7% versus 42.0%, respectively). More rural women had experienced physical violence (28% versus 14%). More urban women experienced controlling behaviors, while more rural women experienced physical violence. In both locations, history of partners' involvement in physical fights was significantly associated with reporting sexual violence (rural: odds ratio [OR] = 3.9; 95% confidence interval [CI] 1.2–12.3; urban: OR = 8.4; 95% CI 1.4–51.8). History of alcohol consumption by partners was significantly associated with reporting physical violence (rural: OR = 2.3; 95% CI 1.2–4.4; urban: OR = 3.2; 95% CI 1.4–7.2). However, among rural respondents, younger partners were more likely to perpetuate controlling behavior (OR = 5.1; 95% CI 1.7–15.6) and being in a relationship for ≥10 years was related to psychological and physical violence. Among urban respondents, history of partners' involvement in physical fights was associated with controlling behavior (OR = 8.2; 95% CI 1.1–65.4) and physical violence (OR = 4.5; 95% CI 1.2–17.3). These results suggest that intimate partner violence is a frequent experience in women in both communities, although the types of intimate partner violence experienced differed, and multidisciplinary strategies are required to reduce intimate partner violence. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inadequate and erratic power supplies mean small businesses use electric generators for alternative power. The authors’ goal in the study described here was to assess noise from electric generators and impacts in the commercial areas of Agbowo and Ajibode in Ibadan, Nigeria. Noise levels (A-weighted decibels [dBA]) were measured over 12 weeks, three times a day, during the 2010 dry season using a sound level meter. A questionnaire was administered (515 respondents; 304 in Agbowo, 211 in Ajibode) and audiometric measurements were conducted on 40% of respondents. Mean noise levels varied by source (104 ± 7.7 dBA [diesel], 94.0 ± 6.3 dBA [petrol]) and were highest midday (90.6 ± 5.3 dBA [Agbowo], 70.9 ± 6.2 dBA [Ajibode]). Mean noise levels in Agbowo (78.5 ± 3.9 dBA) and Ajibode (65.7 ± 4.4 dBA) exceeded World Health Organization guidelines (65 dBA) for outdoor commercial environments. Working and living in Agbowo was significantly associated with current evidence of hearing impairment (odds ratio: 6.8, 95% confidence interval: 3.4–13.7). Reducing exposure to noise from electric power generators serving urban small businesses and homes is warranted. [ABSTRACT FROM AUTHOR]